Family Medicine: An Overview

Family Medicine Overview

• Family medicine provides long-term flexibility in terms of location and work style
• Family physicians are broadly trained, allowing them to adapt to different practice settings
• Family physicians care for all patients, regardless of age, gender, and can establish careers in any community

Special Interests and Opportunities

• Family medicine accommodates those with specific interests, including sports medicine, maternity care, and emergency medicine
• After residency, physicians can pursue fellowship training to further specialize
• The AAFP provides opportunities for students to explore the specialty, including special interest groups and conferences

Common Practice Types

• Expertise is in acute, chronic, and preventative care
• Physicians develop strong relationships with patients and understand the communities they serve.
• Patient-centered care emphasizes team-based approaches, mental health integration, and easy access.
• Common setups include Direct Primary Care, Employed Status, Multispecialty Group Practice, Part-Time Practice, Private Practice, and Rural Practice.

Direct Primary Care (DPC)

• DPC is a model where patients directly pay a flat monthly or annual fee for primary care services
• DPC contracts offer real-time access, extended visits and personalized care
• Patients with DPC retainers are encouraged to have insurance for services outside primary care, like hospitalizations
• DPC gives physicians and patients control over primary care decisions.
• The DPC model can stabilize finances, allowing focus on patients and outcomes rather than billing

Employed Status

• Physicians are increasingly choosing employment in hospitals, community health centers, or multispecialty groups
• A key benefit is not having to manage overhead costs, staffing, or administrative tasks

Multispecialty Group Practice

• Combines family medicine with other specialties like orthopedics and cardiology, improving patient access
• Having multiple services in one location supports better communication and patient convenience

Part-Time Practice

• Physicians may choose part-time work for family, interests, or retirement preparation
• Part-time practice can be economically viable but may present financial challenges
• Job sharing is an option where two physicians share one full-time equivalent (FTE) position, reducing administrative work

Private Practice

• Flexibility exists for family physicians to run their own practices or collaborate in group settings

Rural Practice

• Geographic spread of family physicians closely mirrors the general population distribution
• Physicians in rural areas often face challenges, including illiteracy, poverty, and limited resources
• The National Rural Recruitment and Retention Network aids in finding positions in rural and underserved areas.

Areas of Focus

• Family medicine offers broad training, enabling physicians to align practice with personal interests and goals

Education (Focus Area)

• Family physicians can teach and work with medical students as professors, clerkship directors, or deans
• Opportunities include serving as community preceptors, clinical rotation attendings, or residency program faculty

Emergency and Urgent Care (Focus Area)

• Some family physicians with hospital privileges work exclusively in emergency departments or urgent care centers
• Family physicians often provide the majority of emergency care in rural areas without designated emergency care doctors

Hospitalist/Inpatient Medicine (Focus Area)

• Family physicians provide comprehensive care to hospital patients, regardless of age or medical problem
• They coordinate care among specialists in the hospital
• Roles can be dedicated inpatient physicians, or hospitalists, full-time or rotating basis
• Continuous care can be provided to their patients during hospital stays

International and Wilderness Medicine (Focus Area)

• Family physicians are prepared to address health issues in diverse circumstances, including resource-scarce areas or extreme conditions
• Family medicine’s focus on community and public health enables community assessments

Maternity Care (Focus Area)

• Trained in obstetrics, family physicians may offer full maternity care, including pre- and post-natal care and deliveries
• In underserved areas, maternity care is an essential service family physicians provide

Public Health (Focus Area)

• Many physicians join the National Health Service Corps, working in underserved areas
• Others work for the Indian Health Service, serving approximately 1.5 million American Indians and Alaska Natives across 35 states
• Some physicians consult on grant projects, lead working groups, or pursue advanced public health training

Procedures

• Family physicians are trained to perform various office procedures

Research

• Family physicians collect data on patients and communities
• Research opportunities include primary investigations of federally funded projects or research positions in academic settings

Sports Medicine

• Family physicians can serve as team physicians for various sports, from high school to college and professional levels
• Family physicians are equipped to treat both orthopedic and general medical problems

Work Life Balance

• Family medicine rated high in professional satisfaction and work/life balance
• Practice locations can be urban or rural
• Can pursue additional education, Masters or PHD

Income

• In 2022, average full-time family physician earned $274,359
• High job satisfaction allows physicians to comfortably pay off student loans and support their lifestyle
• Those who practice maternity care can earn an additional $5,000-$15,000 more per year
• There can be $30,000 signing bonuses

Well-being

• Due to seeing a lot of patients wellness is a priority
• Broad practice creates less burnout
• In 2017 reports show 75% were very satisfied with their careers

What Family Physicians Do

• Provide care to patients of all ages and conditions, building relationships
• Act as the patient's first point of contact for health concerns.
• Guide patients through the health care system, coordinating specialist and hospital care
• Utilize data and technology to improve service delivery, access, and coordination.
• Provide care in the context of patients' families, understanding the impact of each member's health on others.
• Know community resources

Medical School

• Training start by attending medical, or osteopathic school
• Then taking the USMLE exams
• Passing earns doctoral degree

Family Medicine Residency

• Post medical school, complete residency in family medicine
• Application done during the last year of medical school
• International Medical Graduates (IMGs) must meet ECFMG requirements and certification for US residency programs
• Residency is at least 3 years

Residency Requirements

• First year is the internship year with rotations
• Also time to study for the USMLE or COMLEX-USA exam
• Next years have training in obstetrics, pediatrics, general surgery, emergency medicine, and inpatient hospital care
• Residents take certification exam by the ABFM or AOBFP
• Apply for state licensure

Advanced Training

• Can do fellowships after residency to help meet special community or professional goals
• Can last 12 months
• Some lead to Certificates of Added Qualifications (CAQs), in addition to recertifying in family medicine
• ABFM offers CAQs in areas like adolescent medicine, geriatric medicine, and sports medicine.